Freeze dried plasma for the resuscitation of traumatized pediatric patients: Response

Roy Nadler, Yael Mozer-Glassberg, Barbara Gaines, Elon Glassberg, Jacob Chen

J Trauma Acute Care Surg 2020 Jun;88(6):e152-e153

While the use of shock index was previously considered as a threshold for blood products use in adults, the Israeli Defense Forces (IDF) current clinical practice guidelines (CPGs) refer to blood pressure and heart rate thresholds. These thresholds are also used by other prehospital systems (1,2). We agree that standard pediatric specific-specific thresholds for prehospital resuscitation with blood products are lacking (3), however, it is important to note that reconstituted FDP is the resuscitation fluid of choice in the IDF, obviating the use of crystalloids. Thus, reconstituted FDP is used mainly to restore lost volume, rather than replacing clotting factors.